Will Pediatric Care Be Maintained in our Community?

In Another Doc Gorn we saw that Dr. Laura Bellstrom closed her pediatric practice in St. Albans, Vermont. She’s number four in a county that had 11 pediatricians at the beginning of the year.

Will pediatric care be maintained?

Yes, it will. NMC and local physicians have been working to ensure that the greater Franklin County community will continue to be well-served by dedicated, caring Pediatricians and Family Practice Specialists. We had hoped to make an announcement of our efforts after all of the contracts were signed, but a recent press release from the Vermont Pediatric Association has created confusion and additional concern in some patients, so I need to take this opportunity to explain how we are proceeding.

The latest round of cuts to the Medicaid reimbursement to physicians has made it even more challenging for private practice physicians to stay in business and has increased the financial losses hospitals carry for the physicians they employ. This hits particularly hard in areas such as ours which have a high percentage of residents on Vermont’s expanded Medicaid program. For Pediatrics, it is a dramatic impact. I believe this has been a driving force in the decisions of four local Pediatricians to leave practice in our area and move out of state, close practice, or seek employment in Chittenden County.

Fortunately, a strong core of Pediatricians and Family Practice specialists continues to care for our community as they have for decades. Pediatrics is a vital preventive, primary care service. With the changes in the healthcare system threatening the sustainability of private practices, NMC has had to get involved to help maintain access to this necessary care.

For weeks, we have been in discussions with the physicians of Mousetrap Pediatrics (Dr. Chip Chiappinelli, Dr. Deanne Haag, Dr. Roya Mansoorani, Dr. Stacy Strouse, and Dr. Heidi Zvolensky) regarding employing them as “Northwestern Pediatrics.” They are currently reviewing the final contracts and have a letter drafted to send to their patients explaining the transition. We have worked closely with them to ensure the transition is as seamless as possible for their patients. We are currently working through the details of medical records transition, billing transition, etc. The great news is, we expect that these trusted physicians will continue to care for their patients. The office locations in St. Albans, Enosburg, Swanton, and MVU will stay the same. Their telephone numbers will stay the same. Nearly all of the familiar faces in the offices will stay the same. This will be a strong step in ensuring access to exceptional Pediatric care in our community continues.

At the same time, we are working with our Medical Staff to recruit additional physicians and advanced practice providers to our community. I am thrilled to announce that one of our strong pediatrician candidates has recently signed a letter of intent to join our staff in 2016. We also have additional strong candidates reviewing the opportunity and we are working to see if one of the physicians might reconsider with the stability of employment at NMC now a possibility.

At 1.9%, our projected operating margin to keep NMC healthy for Fiscal Year 2016 is lower than it has been in years. It is razor thin.

While this is promising news for our community, it is at the same time concerning for our hospital. We offer more “stability” than private practice, but we are not immune to the negative impact of reduced reimbursement. At 1.9%, our projected operating margin to keep NMC healthy for Fiscal Year 2016 is lower than it has been in years. It is razor thin. Taking on additional losses due to reduced reimbursement threatens that margin and our stability. We made this point to the Green Mountain Care Board, the State’s regulators of healthcare, at our budget hearing. Earlier in December, we made this point to our local Legislators, who act on the Medicaid budget. As we reform Vermont’s healthcare system, we must make it less costly through prevention of illness, elimination of waste and duplication, and prudent investment — not through underpayment of the physicians and advanced practice providers caring for the people of our communities.

I look forward to finishing our work with the Pediatricians and our Medical Staff to preserve and expand access to care in our community for children. I apologize to the patients of Mousetrap that this communication was necessary in advance of the letter from your physician; we just could not let parents who were hearing rumors continue to worry as we worked. If you have any questions regarding access to care for children in our community, please call NMC’s Community Relations Office at 802.524.1280. We will do our best to answer your questions and ensure you have the access to care you and your family need.

— Jill Berry Bowen

Jill Berry Bowen is the Chief Executive Officer of Northwestern Medical Center in St. Albans, Vermont. NMC is a 70-bed, private, not-for-profit, accredited community hospital. Dick Harper served on the NMC Board of Incorporators for a decade. This op-ed also appeared in the St. Albans Messenger.